Thank you for your interest in egg donation. Please fill out the pre-screening application. Once it is reviewed, if you meet the initial eligibility requirements, you will receive an email with a link to complete the entire application. Please allow 3-5 days for a response.

1.

Are you currently under a physicians care for any reason?

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If yes, please explain.

2.

Are you a US citizen or permanent resident?

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3.

Are you eligible to work in the United States?

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4.

What is your FIRST name?

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5.

What is your LAST name?

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6.

How long will it take you to get to our office? (5757 Warren Parkway, Suite 300, Frisco, TX 75034)

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7.

Have you applied or been screened to be an egg donor before?

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If yes, provide the name and location of the donor program(s).

8.

Are you currently enrolled as an egg donor in another program?

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9.

How did you find out about our program?

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Please Explain

10.

How many times have you donated your eggs?

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11.

Which ethnicity would you most likely be affiliated?

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12.

Date of Birth (only your calculated age is shared with Recipients)

13.

What is your height?

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14.

What is your weight in pounds?

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15.

What is your highest level of completed education?

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16.

Is your work schedule flexible?

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17.

How many cigarettes do you smoke per day?

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18.

When is the last time you had marijuana?

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19.

How many drinks do you usually consume in a week?

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20.

How many immediate family members have alcohol or drug abuse? (Grandparents, parents, self, siblings, or children)

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21.

When is the last time you have used recreational or illicit drugs (cocaine, LSD, heroin, barbiturates, narcotics, opiates, amphetamines, hallucinogens, tranquilizers, PCP, steroids for non-medical reasons, or etc.)?

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22.

When was the last time you have had a tattoo or body piercing?

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23.

If a background check were run on you, would it show any problems with the law (i.e. DUI, custody issues, lawsuits)?

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If yes, please explain.

24.

Have you ever had any arrests, convictions, sentences, etc.?

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If yes, please explain.

25.

What is the most number of consecutive days that you have been incarcerated?